Cancer drugs fund in Wales? My blatherings on the BBC

2 minute read time.

There is a big debate raging in Wales about the Cancer Drugs Fund available in England. This fund enables patients in England to access drugs that would not otherwise have been routinely available from the NHS. Many in Wales now demand the same thing. Scotland also does not have such a fund, though I do not know what the state of the debate there is. 

This morning there was a phone-in on BBC Radio Wales about this. It is of course very emotive. The debate often manifests itself as a simple question "if I lived in England drug X would be available to me but because I live in Wales it is not - this is unfair." This seems to me to be one of those classic debates where, very understandably, the answer seems so simple but if you examine things in a little more depth, it isn't. 

The Cancer Drugs Fund (CDF) in England is both managed and funded by NHS England. So it seems like another way of saying, OK, under certain circumstances, we will also pay for drugs that we don't normally pay for. The site says "There is a single, national list of drugs and indications that the CDF will routinely fund and standard operating procedures for administration of the fund." It does not seem to me like a way of giving access to wonder-drugs (which, unfortunately, hardly ever exist anyway) but more a way of slightly extending the range of drugs available through NHS England under certain circumstances etc. So, although highly emotive, it is only a very small part of a much larger picture. For example, would it make more sense to put the money into more radiography machines instead, to reduce waiting times, rather than into a drugs fund?

Anyway, I could not resist calling into Good Morning Wales, where I am known a little bit from previous discussions around the EU. 

I made a few points which were basically about the need to get a more holistic picture and how putting the issue into a European context can help. For example, UK cancer survival rates are below the EU average, but Wales appears to be slightly better than England. Figures may be slightly dated at 2009 but see page 27 here:  http://www.cancerresearchuk.org/prod_consump/groups/cr_common/@nre/@pol/documents/generalcontent/cr_071282.pdf 

Also, it is possible, subject to several conditions, to receive treatment in other EU countries, not just different parts of the UK. See http://www.nhsdirect.wales.nhs.uk/travelhealth/FundingOptions/ 

This is a complex issue, but I am beginning to wonder whether the CDF isn't partly a political stunt. What would be more helpful would be a more holistic approach - and a more holistic debate.  Rising rates of cancer are not, as is commonly assumed, merely a result of us living longer. They are largely also caused by environmental and lifestyle factors. Here's another interesting little fact - the UK is now officially the most obese country in Europe, and there is a known link between obesity and cancer, not to mention a host of other diseases. Rather than focus on drugs funds, maybe we should think about what the food industry is getting away with....

In the unlikely event that you should wish to subject yourself to my oral as well as written rantings, you can catch the programme on BBC Player, with my star turn at around 53 minutes:

http://www.bbc.co.uk/programmes/b05xhyws

Thanks all, take care.

Anonymous
  • FormerMember
    FormerMember

    I may be wrong but I have been led to believe that one of the reasons English patients get this and not welsh or Scottish is because in england the general population pays for prescriptions while in Wales and Scotland they are free so the money is not available. Is this correct? 

  • That's a very good point. There is no direct trade-off between free prescriptions in Wales and Scotland and the fact that there is no Cancer Drugs Fund there. They are two separate points and two separate logics. Nevertheless, it is true that if you are spending more on free prescriptions then you have less cash for other things - like cancer treatment.

    Personally, I think free prescriptions is a thoroughly misguided policy. It treats people who can usually afford your average prescription, like me, in exactly the same way as those who can't. Worse, it is effectively a blank cheque for the pharma industry and a way for GPs to send away patients with a few drugs that will palliate the symptoms but not cure the problems. Anti-depressants are one of the best examples of that, antibiotics used to be.

    I lived in Belgium for 18 years and there you paid for your prescription and got back 75/80 % from your state regulated health insurance. This meant that somebody was keeping an eye on prescription costs and GPs working under pressure were not subject to the temptation to deal with the patient just by giving them a few sweeties and sending them away. (Consulation time with a Belgian GP was much longer than here, usually 2-3 times longer.)

    But this does not mean that if you stop free prescriptions then the best thing for cancer patients is a cancer drugs fund. It may be more radio machines to cut waiting times, or better levels of training for staff (or proper anti-cancer food in hospitals .....) That is why I am a bit suspicious of the fund in England. There is nothing more emotive than a headline in the Welsh press (such as it exists) about someone "forced to move England" to get access to a drug not available here. But the Cancer Drugs Fund in England is both managed and funded by the NHS there, meaning that it is not really anything special and simply means that a few more drugs might be available in England, which might (stress on "might") be more effective. Which brings us back to square one, namely the difficult debate about which drugs should be prescribed and which ones can be afforded... Whether that is by some gimmicky bolt-on fund or not does not seem to me to be particularly relevant

    Thanks for the comment and the interest!

  • FormerMember
    FormerMember

    Thank you Cymru123 for this thought provoking discussion.

    We have made you part of our featured content on the homepage this week.

    All the best,

    Jess

    Macmillan Community Team

  • Gosh, thank you Jess. I am glad you found it interesting.

  • FormerMember
    FormerMember

    David, you can't keep off the air even though you're ill! Its great to see you've been keeping yourself busy. As to the story itself, I don't know any of the detials unlike you, but I have to agree it soulds more like window dressing than anything else!